Organ donations rising across the UK

A record 170 organ donations took place across the UK in January, resulting in more than 400 life-saving transplants.

The rise in numbers comes as the NHS is running a public consultation into whether England should follow Wales and introduce an opt-out donation scheme.

The online consultation has so far had more than 11,000 responses; a huge amount bearing in mind similar surveys usually attract a few hundred replies.

The NHS's Claire Williment said: "It has got the nation talking."

Mrs Williment, head of transplant development for NHS blood and transplant (NHSBT), said this was "a positive thing".

Families consulted

Anthony Clarkson, assistant director of organ donation and nursing at NHS Blood and Transplant said: "January was by far the busiest month on record for organ donation thanks to 170 very special individuals.

"Thanks to the generosity of organ donors and the support of their families, people in desperate need of a transplant are getting a second chance at life," he added.

how much say should families have in their deceased relative's decision to donate their organs?

when would exemptions to opt out be needed and what safeguards will be necessary?

how might a new system affect certain groups depending on age, disability, race or faith?

Under the current system in England, people who want to donate their organs opt in by signing up as a donor on the NHS organ donor register and telling their family their decision.

If a decision has not been recorded at the time of a person's death, hospital staff will consult family members on whether organ donation should go ahead.

Of the 600,000 people who died in the UK between 1 April 2016 and 31 March 2017, only 5,681 were eligible donors, but after donation requests were made to families only 1,413 became donors.

Families are always consulted before a donation takes place and 91% of them agree to it if their relative is on the organ donation register (ODR), according to figures from the NHSBT potential donor audit.

However, when patients are not on the ODR then 47% of families say no to a donation.

On average, one organ donor contributes to three transplants but it is possible for their organs or tissue to be used in up to nine people.

One option for the future in the consultation is for a person's donation decision to be respected after their death, without their family being asked.

However, Mrs Williment said any decision on a change like that would be down to the Department of Health.

Dr Dale Gardiner, deputy national clinical lead for organ donation and intensive care consultant at Nottingham University Hospitals NHS Trust, said that donation should be considered to be "a fundamental part of end of life care".

He added: "It is the most humbling moment of my career in intensive care when a family look beyond their grief and say yes to donation.

"The worst moment is when families do not know their loved one's wishes," he added.

NHSBT figures show that donor numbers in the UK have increased in all but one of the past 10 years, while the number of people on the transplant waiting list has decreased every year since 2009-10.

Keith Rigg, consultant transplant surgeon at Nottingham University Hospitals NHS Trust, admitted that opt-out may not be the way to raise the number of donors in England even higher.

He felt that full results from Wales should be studied before such a move was considered in England.

"There is no clear evidence that this has resulted in an increase in organ donations and transplants where it has been introduced," he said.

"There do appear to be higher rates in countries where there this has been brought in but many other factors muddy the waters.

"For example, in the three European countries with the highest organ donation rate – Spain, Croatia and Portugal – the reason is down to [other] changes," he explained.

About 80% of transplant patients are waiting to receive a new kidney.

Fiona Loud, policy director at Kidney Care UK, said: "One person dies every day whilst waiting for a kidney transplant; it is abundantly clear that we need to review our current system now to stop this continuing."